Dysautonomia

What is dysautonomia?

Any malfunction/disease of the autonomic nervous system (ANS) is called dysautonomia (previously known as Neurasthenia, or weak nervous system). The autonomic nervous system is responsible for controlling a number of important involuntary functions such as blood pressure, digestion, heart rate and breathing. ANS consists of the sympathetic and parasympathetic nervous systems. The sympathetic nervous system controls the flight and fight reactions of the body while the parasympathetic nervous system controls the quiet body activities. In normal and healthy people, there is a balance between these two; this balance is hindered in individuals suffering from dysautonomia.

Postural orthostatic tachycardia syndrome (POTS), inappropriate sinus tachycardia (IST), vasovagal syncope, pure autonomic failure, neurocardiogenic syncope, neutrally mediated hypotension, orthostatic disorders (e.g. – cerebral salt wasting syndrome), and irritable bowel syndrome (IBS) are all forms of dysautonomia.

Diseases which affect the nervous system, like diabetes mellitus, multiple system atrophy, Guillain Barre syndrome, Lyme disease, Parkinson’s, Ehlers-Danlos syndrome, Botulism, autoimmune disorders, etc. can cause dysautonomia. Injuries to the brain or other parts of the ANS, mitochondrial diseases, viral diseases, genetic factors, exposure to chemicals, trauma to the head and/or chest can also result in dysautonomia. Some women who have underwent breast implantation surgery have also reported cases of dysautonomia experienced after their surgery.

Dysautonomia caused by viral infections or exposure to toxic chemicals and trauma occurs suddenly, while dysautonomia caused by other reasons is slow and progressive.

Symptoms of Dysautonomia

As there are different types of dysautonomia (and because the constitutions of people vary) the symptoms widely vary from individual to individual. They may also vary in severity. (Most people with this condition can perform their day to day activities, but some become permanently bedridden.)

Excessive fatigue, light headedness/dizziness, excessive thirst, panic attacks or anxiety, rapid or slow heart beat rates, gastro paresis, headaches/migraines, malaise, pallor, salt cravings, orthostatic hypotension, convulsions, constipation, diarrhea, occurrence of a faintish feeling or fainting, acid reflux, frequent urination, chest pain, cognitive impairment, visual disturbances, seizures and loss of consciousness are the symptoms of this condition.

In some individuals, all these symptoms may appear together while in others only a small group of symptoms may occur at one time. In some people, symptoms are hardly identifiable.

Symptoms may appear and disappear. It is also very difficult to correctly diagnose this condition correctly. The condition of children with dysautonomia usually improves with aging. Viral like symptoms (sore throat, muscle ache, fever) are usually the warning signals of this disorder. Physical activities and ingestion of certain foods can trigger symptoms of this disease.

Treating dysautonomia

There is no permanent cure for dysautonomia. Treatment is done to suppress the symptoms and disabilities associated with the disease. Treatment varies from person to person; the method of treatment is determined according to their constitutions and the symptoms displayed.

Pharmacological drugs, dietary supplements, physiotherapy (physical activity), chronic disease counseling, etc. are used as treatment methods.

Dysautonomia medications

1. Anti anxiety drugs. Anti anxiety drugs are used to control anxiety in patients who undergo panic attacks. Xanax and Ativan are two drugs which are commonly used.

2. Tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs). Tricyclic antidepressants like Elavil, Norpramin, and Pamelor in small doses and SSRIs like Prozac, Zoloft, and Paxil are used for treating depression experienced by patients. Studies say that they might even have the ability to rebalance the ANS.

3. Non-steroidal anti-inflammatory drugs (NSAIDs). The pain resulting from fibromyalgia and other conditions of dysautonomia can be suppressed using NSAIDs. Advil and Aleve are two commonly used NSAIDs.

4. Anti-low pressure drugs. Anti–low pressure drugs like Florinef help to manage orthostatic hypotension which is a common symptom associated with vasovagal syncope and POTs.

Diet

Individuals with this disease are advised to drink two liters of fluid a day along with enough sodium to increase their blood volume.

Dietary supplements, herbal remedies, vitamins and coenzymes are also used to treat this condition. However, the benefits of this particular treatment are not well researched.

Physiotherapy (physical activity)

Physical therapy/activity is of vital importance to patients with dysautonomia. When this condition was known as Neurasthenia (in the past), patients were advised to get plenty of bed rest. As a result, they became permanently bedridden. Nowadays, having an adequate amount of physical exercise daily is recommended. It is said that physical activity stabilizes the nervous system and makes relapses of symptoms rarer and shorter in duration in the long run. Apart from physiotherapy, yoga, Tai-chi, massages and stretching therapy have proven to be beneficial for individuals with this disorder.

Other dysautonomia facts

• Simple techniques like elevating the head of the bed help to minimize the symptoms of orthostatic hypotension.
• Compression stockings are used to prevent blood pooling in the legs.
• Symptoms of most people with dysautonomia go away eventually or reduce to a point of becoming bearable.
• Individuals who suffer from some types of dysautonomia, like Guillain Barre, may gradually begin recovering, while other fatal types, like multiple system atrophy, may be diagnosed with a life expectancy of 6 – 10 years.
• Those with orthostatic hypotension carry the risk of suffering a stroke.
• Deaths may occur due to pneumonia, acute respiratory failure or sudden cardiopulmonary arrest in patients with chronic progressive dysautonomia.

Knowledge regarding dysautonomia is lacking at present and research is currently being pursued by leading medical institutions to facilitate diagnosis, treatment and prevention of this condition.